Causes and consequences of adult obesity: health, social and economic impacts in the United States

Obesity has been identified as an epidemic in the United States for more than two decades and yet the numbers of overweight and obese adults and children continue to grow. Currently, the rates of both overweight and obesity in the US are 61% and 14% in adults and children, respectively. Among US adults aged 20-74 years, the prevalence of overweight (defined as BMI 25.0-29.9) has increased from 33% in 1980 to 35% of the population in 1999. In the same population, obesity (defined as BMI greater than or equal to 30) has nearly doubled from approximately 15% in 1980 to an estimated 27% in 1999. The percentage of children and adolescents who are defined as overweight has more than doubled since the early 1970s. About 14% of children and adolescents are now seriously overweight. Obesity burdens the health care system, strains economic resources, and has far reaching social consequences. The disease is associated with several serious health conditions including: type 2 diabetes mellitus, heart disease, high blood pressure and stroke. It is also linked to higher rates of certain types of cancer. Obesity is an independent risk factor for heart disease, hypoxia, sleep apnea, hernia, and arthritis. Obesity is the seventh leading cause of death in the US. The total cost of overweight and obesity by some estimates is $100 billion annually. Others put the cost of health care for obesity alone at $70 billion. Other annual costs associated with obesity are 40 million workdays of productivity lost, 63 million doctors office visits made, and 239 million restricted activity days and 90 million bed-bound days. Emotional suffering may be among the most painful aspects of obesity. American society emphasizes physical appearance and often equates attractiveness with slimness, especially for women. Such messages may be devastating to overweight people. Many think that obese individuals are gluttonous, lazy, or both, even though this is not true. As a result, obese people often face prejudice or discrimination in the job market, at school, and in social situations. Feelings of rejection, shame, or depression are common. Since the 1950s, national dietary recommendations have come to acknowledge obesity as a significant societal trend. The Surgeon General's 2001 Call To Action, Healthy People 2010, and the Dietary Guidelines for Americans 2000 all emphasize the importance of healthy weight. There are some new tools available to help in the fight against overweight and obesity: Weight Control Information Network, The Third National Cholesterol Education Program's Adult Treatment Panel, and The Practical Guide: Identification, Evaluation, & Treatment of Overweight & Obesity in Adults from the National Institutes of Health and National Heart Lung and Blood Institute.